| NPI | 1083051601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OK 35640) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MD D0085873) |
| 2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: MD D0085873) | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: OK 35640) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 301729) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2021-11-09 |